Random thoughts from a few cantankerous American physicians. All contributors are board certified. Various specialties are represented here. I do not know where this will lead but hope it will at least be an enjoyable read. All of the names mentioned in this blog are pseudonyms, the ages have been changed, and in half the cases the gender as well. All photographs are published with patient consent or are digitally altered to preserve anonymity. Trust us, we're doctors.

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Saturday, December 22, 2007

Spoke to a friend today who happens to be a nephrologist. He is currently taking care of a Bangladeshi woman who flew directly here to Podunkville after a physician in Bangladesh told her she would need dialysis but could not get it there. Turns out she has relatives here in the den of Satan... the imperialist/capitalist empire known as America.

I happened to be looking over his shoulder as he was on the internet and he was reviewing a strange looking document which was written in broken English. It was the patient's medical record from her home country.

This nice gal does indeed have renal failure, and needs to start hemodialysis. She did manage to scrape together the money to get here, but can not pay her medical bills now that she has arrived. Turns out that in the course of her evaluation she was found to have severe coronary artery disease and will need a simple multiple coronary artery bypass graft among other things. She's going to live here now and get all the medical care she needs. I think it's great. We will definitely help her out. The only problem is for you, the taxpaying public. Open your hearts people! (your wallets have already been opened by federal law).

Merry Christmas and Happy Kwanza-Rama-Hannukan. Thank you again, American public

21 comments:

She came from another country and can get all her medical needs taken care of, paid for by the taxpayers. My husband was born in this country. He worked and payed taxes for 30 years. Now I'm having to fight to get adequate healthcare for him. Tell me how this is right.

It's been a while, almost 10 years; and Medicaid rules vary from State to State. NY and Cali have the laxest rules of all.

What always baffled me, when I did Medicaid eligibility in TX, was how an immigrant could get Mediciad. Supposedly, one of the INS, or ICE, now, rules for admission is that an immigrant have a SPONSOR. One of the things that sponsor promises is to support the immigrant for the first 2 years they live in the USA. That support is to include food, shelter, clothing and MEDICAL Care. If our citizens would start DEMANDING that the laws be enforced, like immigration law, then we would not be seeing immigrants receiving free medical care when lifelong, taxpaying citizens cannot get free aspirin!

What horseshit (the last person who claimed I had a heart was declared legally insane). Okay, from a humanistic side, it's lovely she's going to be helped but, I resent the crap out shelling out my hard-earned dimes to help pay for it(and I grow faint at guesstimating the cost). How is this remotely possible (being rhetorical here) when a young girl just died because her health insurers refused to allow her kidney transplant? It just doesn't pay to be a legal American anymore, does it? The only thing we're good for is to fund the blank checks by our enlightened politicians. Ach, who is John Galt?

You left out the really good part of this story. The part about where the lawyers get to sue all of your friends who will do this, gratis, if ANYTHING happens to go wrong with any aspect of her free care.

Medical bills are easy to quantify, as are country of origin of the leach, er, visitor. The U.S. donates well over 200 million to Bangladesh every year. If this cost would have been absorbed in Bangladesh anyway, why can't we deduct it from their aid? Is that too simple?

Whoa. Speaking from across the pond, I had no idea this could happen in the USA. As a foreigner myself, I think it's great that the American medical system provides hope to immigrants like this, but I also don't see how their care should come before that of American citizens. It IS your country, after all.

Ah well. Like they say in all the TV shows we get over here in England, "Only in America!" =)

This fucking sucks. I just found out that my follow up chest CT from last week has more something in it than it used to 6 months ago, and is either pneumonia (which my doctor is hoping because I do have a yucky cough and am very very tired) or more cancer. It really pisses me off that I am paying all my fucking bills and slowly draining my kids college funds while someone can come here and get everything taken care of for free. I'm happy this person is getting the help they need, but pretty annoyed that they won't have to/can't pay for it.

Happy holidays. Sorry I'm so grumpy today...I'm on an antibiotic which is having a nice placebo effect on me in that I want it to work so badly and prove that it's just pneumonia that I actually think it is working. We'll see.

Rad Girl, Those of us who believe in it will pray for you, those of us who don't send their best wishes. Please do update us as soon as you have something definitive. Have missed your presence here recently and I'm sad it's with potentially bad news that you return. Hope you feel better tomorrow.

I'm not a religious person, but if you apply "What Would Jesus Do" it would be to provide her the dialysis even if it reduced the financial resources of the people living in her new community to do so. The only people Jesus was harsh with were the religious hypocrites; his interest was in helping the poor and socially rejected.

"What Would Jesus Do"...provide her the dialysis even if it reduced the financial resources of the people living in her new community Requesting permission to roll my eyes now. Tell me; what would Jesus do once the resources have been forcefully drained from financing the care of all those lost (illegal, uninsured) lambs? Give me a break.

Rad girl: I hope you have pneumonia. Never thought I'd wish that on someone before. I'm not sure if that's what Jesus would do...I think 911 is right, he's just cure you. But our thoughts and prayers are with you.

Radioactive Girl - please do post again and let us know how you are. I just spent 8 days in a hospital with pneumonia and if you have that you need to plan on a one month recovery period. I'm halfway through it and doing only mild exercise and staying away from crowds of people who might pass on colds or viruses while my immune system is still recovering.

ha haSee this shows your lack of experience with medical tourism. Here in Canada they used to arrive every damn day. They literally drove straight from the airport to the ER demanding dialysis. They don't ask..they demand.We have become crafty and sneaky..we accept them as outpatients and then we contact their embassy.We tell the embassy we are going to treat and then bill the embassy for the treatment.See the patient cannot pay..ever but the embassy has to because if they don't we sue them.By accepting them as patients we don't break any rules but by contacting their embassy we make it damn uncomfortable for them to stay in the country.The embassy will force them to leave because they do not want to pay the cost of their care.It's sneaky but on the whole it works.Our other trick is to get any family member who is a citizen and there is always one to sign the forms that say they are responsible for the bill. We sue them too.If they refuse we tell them we will have to contact immigration to find out who sponsored this person to come into the country.We then tell the patient they refused to sign and watch when all hell breaks loose.As long as these people aren't sick enough to need a bed and come on they just rode on a airplane for ten hours obviously they don't need hospitalization we give them an outpatient appointment as soon as they prove someone Canadian can pay their bill.If they need a bed we go straight to the embassy.Another fact..we offer one dialysis treatment only . We tell them they must book a return flight immediately and we give them one dialysis treatment for the road. We have also had the "needs a bypass" too...we don't offer it.We provide only the care required to get them to their flight home. If they pretend they don't have a ticket yet we call immigration and get immigration to expedite their leaving.We have spent billions on these people in the past. They offer nothing in return. We boot them out as quickly as we can with the help of all our resources.If you're smart you'll forget about your INS and start contacting their embassy.Remember if their problem isn't emergent you are not obligated to treat. Your only obligation is to get them on that return flight asap. There are no rules about pushing the immigration, embassy and visa angle. There are no rules about canvassing the family about who will be paying the bill.Don't do what we did and cave . Make them uncomfortable as hell about payment without actively denying them MINIMAL treatment.NEVER offer them anything but basic care and tell them straight up they will be sent home to get the care they need. Ignore them whining they can't get it..yes they can..they just have to pay for it at home.Medical centers exist in Pakistan and India that are as progressive as any hospital here. They cost money too.If they can afford a five thousand dollar plane ticket they can afford care in their home country.

We had a Laotian dude who was on dialysis go back to his homeland for a visit. He had dialysis all set up there and apparently went. Upon arriving back in the US, he went right to the ER and said that the ghettorific dialysis machines in Laos "do not pull fluid off", they only remove toxins. I'm not sure if that makes sense, but he was admitted to have a few liters of fluid removed.